Advise on reducing night time insulin when lo carbing

[sandiegirl]

Hi, Could anyone advise me on how much I should reduce my night time insulin by? I am starting today to lo-carb as things have got seriously out of control for me over the past few weeks. I am type 2 diagnosed 4 years ago. Started out on diet but then went onto tablets and i am now on the folloiwng injections:

Novorapid - 26 units at breakfast
Novorapid - 26 units at lunchtime
Novorapid - 32 units at dinner
Lantus - 50 units at nighttime

Take also 2 x 500g metformin in the morning and 2 again at nightime along with atvorstatin.

To give u some idea, my morning BS was today 15.8 before breakfast, had my breakfast of 100g of lowfat organic greek yoghurt with some sunflower seeds and sweetener, had my 26 units of novorapid and my BS 2 hours later was 9.7 - this is pretty good for me. I realise that I should adjsut my dosage of insulin now that I am low carbing and this will be trial and error until I get it right, but my biggest wory is my night time one. during the day, if I have a hypo, then hopefully I should be able to deal with it, but what happens at nighttime? I know i probably sound very naive, but to be honest I have got myself in such a pickle reading the books that were recommended - Dr Bernsteins - that I am in a bit of rut now! So could someone please help me with some advise. I plan to hopefully stick to approximately 30gm of carbohydrate daily - 6gm at breakfast, 12 at lunch and 12 at tea and see how I get on . I am very overweight and need to lose about 5-6 stone. But I am so determined now to do it - and reading all teh threads on here has given me the push to get going with it. Ss sorry for the long message - this is all my pent up worries com ing out!
Thanks,
Sandie

 

[fergus]

H Sandie,

As for your Lantus dose, your risk of hypo is very srongly related to the size of the dose (sorry if that's too obvious). 50 units is a very large dose. In your position I would simply split the dose in half - take one half at bedtime and the other in the morning.
This way, you will greatly reduce your overnight hypo risk and probably get better basal coverage over a 24 hour period too.
Your insulin doses are generally very high, it does sound as if you have quite significant insulin resistance. Be careful to reduce these doses too, and slowly, as you reduce the carbs in your diet. Your weight should begin to reduce and as it does so your insulin resistance will also reduce. Allied with the reduction in carbs, you may find your doses get quite a bit smaller in time.

Good luck with it and please keep us posted.

fergus

 

[sandie2255]

Thank u so much Fergus, that sounds like a plan to me!
No honestly, that really helps. I just couldnt work out what to do tonight as I realise that 50 units is very high and I was seriously worried about having a night time hypo. I will split it in two as you suggest, and take 25 units tonight and 25 units in the morning. I will post back in a few days to let you know how things are going, i just really want to get my BS numbers to below 5. And then hopefully the weight will also begin to go.
thanks once again for your message.
Sandie.